When should you pull out your child’s baby teeth?

Though it’s not common, extraction of baby teeth during a child’s early years can be a necessary dental procedure. Usually this is a last resort, as this dentition has some pretty important functions in the mouth. They are essentially place holders for the permanent teeth, help with speech and chewing development, and aid in nutrition and bodily growth. So what are some reasons to have your child’s teeth removed? Let’s take a look at a few examples and then discuss the process of extraction.


A Condition Coined as Shark Teeth
One of the biggest freak outs parents can have is when the permanent teeth come up behind the baby teeth before the baby tooth loosens appropriately. This gives the illusion of two rows of teeth similar to a shark’s oral cavity, thus the name. Around age six, this can happen with the front teeth, and later around age 11 the molars can have a similar situation occur. This usually happens when the baby tooth’s root is stubborn to dissolve or the permanent tooth isn’t directly underneath it, pressing up to hasten the root breakdown. The permanent tooth will then take the path of least resistance and come up behind. Generally, the baby tooth will still dissolve, just at a slower pace. If, however, the baby tooth stays put for more than three months after the permanent tooth is fully erupted, a visit to the dentist is warranted. He or she can evaluate any problems and make a decision as to whether to remove the baby tooth or any others adjacent baby teeth that may hinder upcoming permanent teeth. (Source: intelligentdental.com)


Mesiodens: A little Something Extra
Mesiodens are additional teeth or pieces of teeth that grow up between or behind the other teeth. They can restrict the normal eruption of the teeth, leading to crowding or impaction. Sometimes they can be caught early by x-ray, while other times they’ll erupt beside or behind other teeth. Most dentists will remove these as soon as they are found to make the teeth surrounding them slide easier into place or to start orthodontic treatment.


In the Case of Damage
Let’s face it, children are really good at getting hurt. Falls, accidents, and sport mishaps often lead to tooth or oral damage. If a primary tooth is beyond salvageable, a dentist will often opt to remove it. This can also encourage the permanent tooth to come more quickly as well as prevent decay from taking advantage of a fractured and vulnerable tooth.


A Note on Complications
Not every tooth extraction is a quick fix pulling. Your dentist may conclude that a tooth’s removal may need to be done by a specialist such as an oral surgeon. You should respect this decision, as your child’s case may be more difficult due to fractures or chips, acute decay, or abnormal tooth anatomy. The specialist can offer more experience in these types of extractions, as well as have the necessary sedation available to make sure your child is calm and comfortable through a more rigorous procedure.


The Parents’ Role During and After Extraction
If you’re child situation is pointing to an extraction or two, you need to be aware of what to expect, how to respond, and what sort of follow up will be necessary to ensure the safety and protection of your child’s remaining teeth. The first thing we recommend is to stay calm. Your child reads your emotions and reactions well, and will respond accordingly. Speak with your child and answer any questions they have. Be honest with them about what to expect but reassure them it’s in their best interest.
The dentist will also request a consultation prior to the extraction to discuss anesthetic options. Even at the highest levels allowed, the child will still feel the tug of the extraction. If the tooth is considered a “hot tooth,” infection is present and the pain may override the anesthetic. In this case, the dentist may prescribe some antibiotics for the days leading up to the extraction appointment.


Once the teeth have been extracted, your child will need to remain in the office until bleeding has slowed or stopped. Occasionally, anesthetic doesn’t wear off for an hour or more. If this is the case, your child needs to know not to use their tongue or to suck or touch the extraction sight, as it can disrupt the scabbing and damage surrounding oral tissue. Post-procedure instructions will be given as far as food and drink limitations, care directions for the wounded socket, and activity restrictions until healing is complete.


Follow up visits may be necessary depending on the procedure and how it heals. Infection or excessive pain is a reason to call to come back in. Additionally, space maintainers may be needed in cases where the tooth was extracted before the permanent teeth have begun to erupt. Several types are available, and usage will depend on your dentist’s suggestions and expertise.

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